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American Journal of Epidemiology Vol. 132, No. 1: 144-156
Copyright © 1990 by The Johns Hopkins University School of Hygiene and Public Health

research-article

A PROSPECTIVE STUDY OF PERSISTENT DIARRHEA AMONG CHILDREN IN AN URBAN BRAZILIAN SLUM

JOHN B. SCHORLING1, CHRISTINE A. WANKE1 2, SOPHIA K. SCHORLING1,, JAY F. McAULIFFE1,3, MARIA AUXILIADORA DE SOUZA4 and RICHARD L. GUERRANT1

1Division of Geographic Medicine, University of Virginia School of Medicine Charlottesville, VA
3Project Hope/Brazil Fortaleza, Ceará, Brazil
4Department of Community Medicine, Federal University of Ceará Fortaleza, Ceará, Brazil

Reprint requests to Dr. John B. Schorling, Box 494, University of Virginia Health Sciences Center, Charlottesville, VA 22908

Persistent diarrhea is a major health problem among children in developing areas of the world. Since few community-based studies have addressed the epidemiology or etiology of this condition, we undertook prospective diarrheal surveillance among a cohort of 175 children less than 5 years of age over a 28-month period in an urban slum in northeastern Brazil. Very high diarrhea illness burdens were found. The children in this cohort had an average of 11 episodes per year and spent 82 days per year with diarrhea. A total of 65% of children had at least one episode of persistent diarrhea (≥14 days duration). These episodes accounted for 50% of all days of diarrhea and 11% of all episodes. The occurrence of at least one episode of persistent diarrhea identified all children who spent at least 15% percent of days with diarrhea. Among children with and without diarrhea, rotavirus was the agent isolated most frequently, followed by Giardia lamblia and enterotoxigenic conforms. The agents isolated from children with acute and persistent diarrhea were similar, which suggests that other factors must be operative in the development of persistent diarrhea.

child; developing countries; diarrhea; diarrhea, infantile; Escherichia coli infections; Giardia; rotavirus infections

2Current address: Division of Infectious Diseases, New England Deaconess Hospital, Boston, MA


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